University of Illinois at Chicago, Chicago, IL, USA.
University of Minnesota, Minneapolis, MN, USA.
Value Health. 2023 Oct;26(10):1494-1502. doi: 10.1016/j.jval.2023.06.001. Epub 2023 Jun 9.
A major strategy to reduce the impact of breast cancer (BC) among African Americans (AA) is patient navigation, defined here as individualized assistance for reducing barriers to healthcare use. The primary focus of this study was to estimate the added value of incorporating breast health promotion by navigated participants and the subsequent BC screenings that network members may obtain.
In this study, we compared the cost-effectiveness of navigation across 2 scenarios. First, we examine the effect of navigation on AA participants (scenario 1). Second, we examine the effect of navigation on AA participants and their networks (scenario 2). We leverage data from multiple studies in South Chicago. Our primary outcome (BC screening) is intermediate, given limited available quantitative data on the long-term benefits of BC screening for AA populations.
When considering participant effects alone (scenario 1), the incremental cost-effectiveness ratio was $3845 per additional screening mammogram. When including participant and network effects (scenario 2), the incremental cost-effectiveness ratio was $1098 per additional screening mammogram.
Our findings suggest that inclusion of network effects can contribute to a more precise, comprehensive assessment of interventions for underserved communities.
减少非裔美国人（AA）乳腺癌（BC）影响的主要策略是患者导航，这里将其定义为减少医疗保健使用障碍的个性化帮助。本研究的主要重点是估计纳入导航参与者的乳房健康促进和网络成员可能获得的随后 BC 筛查的附加价值。
在这项研究中，我们比较了两种情况下的导航成本效益。首先，我们检查了导航对 AA 参与者的影响（方案 1）。其次，我们检查了导航对 AA 参与者及其网络的影响（方案 2）。我们利用了南芝加哥多项研究的数据。我们的主要结果（BC 筛查）是中间的，因为关于 AA 人群 BC 筛查的长期益处的定量数据有限。
仅考虑参与者的影响（方案 1）时，每增加一次乳房 X 光筛查的增量成本效益比为 3845 美元。当包括参与者和网络的影响（方案 2）时，每增加一次乳房 X 光筛查的增量成本效益比为 1098 美元。
我们的研究结果表明，纳入网络影响可以为服务不足的社区的干预措施提供更精确、全面的评估。
